Skip to main content
Erschienen in: The journal of nutrition, health & aging 6/2018

17.05.2018

Effect of a Minimal-Massive Intervention in Hospitalized Older Patients with Oropharyngeal Dysphagia: A Proof of Concept Study

verfasst von: A. Martín, O. Ortega, M. Roca, M. Arús, Pere Clavé Civit

Erschienen in: The journal of nutrition, health & aging | Ausgabe 6/2018

Einloggen, um Zugang zu erhalten

Abstract

Background

Oropharyngeal dysphagia (OD) is a newly defined geriatric syndrome that causes nutritional and respiratory complications in older hospitalized patients. Following hospital discharge, OD also causes hospital readmission and mortality in this population.

Objective

Our aim was to assess the effect of a minimal-massive intervention (MMI) in reducing nutritional and respiratory complications in older hospitalized patients with OD.

Design and participants

An open label trial was performed on 186 hospitalized older patients (>70y) with OD; 62 of these patients with OD were treated with the MMI and paired by sex, age, functionality, comorbidities and body mass index with two controls.

Intervention

The MMI consisted of: a) fluid thickening and texture-modified foods, b) caloric and protein supplementation; and c) oral health and hygiene recommendations during hospitalization and following discharge. The control group followed the standard clinical practice without MMI.

Measurements

Main study outcomes were hospital readmissions, respiratory infections, nutritional status and survival after 6 months follow up.

Results

Both groups had similar advanced age (84.87±6.02MMI and 84.42±5.31 years), poor functionality (Barthel 59.51±26.76 MMI and 58.84±26.87), and high comorbidities (Charlson 3.00±1.60 MMI and 3.06±1.45). Main results showed that MMI improved nutritional status (MNA 9.84±2.05 pre-MMI vs. 11.31±2.21 post-MMI; p=0.0038) and functionality (Barthel 62.34±25.43 pre-MMI vs. 73.44±25.19 post-MMI; p=0.007). In addition MMI decreased hospital readmissions (68.8 readmissions/100 persons-year (28.1–109.38) MMI vs. 190.8 (156.0–225.7); p=0.001), respiratory infections (12.50 readmissions/100 persons-year (0–29.82) MMI vs. 74.68 (52.86–96.50); p=0.002), and increased 6-month survival (84.13% MMI vs. 70.96%; p=0.044).

Conclusions

Our results suggest that a MMI in hospitalized older patients with OD improves nutritional status and functionality and reduces hospital readmissions, respiratory infections and mortality. MMI might become a new simple and cost-effective strategy to avoid OD complications in the geriatric population admitted with an acute disease to a general hospital.
Literatur
1.
Zurück zum Zitat World Health Organization. International Classification of Diseases (ICD). Geneva; 2010. World Health Organization. International Classification of Diseases (ICD). Geneva; 2010.
2.
Zurück zum Zitat Altman KW, Yu G-P, Schaefer SD. Consequence of Dysphagia in the Hospitalized Patient. Arch Otolaryngol Neck Surg. 2010;136(8):784.CrossRef Altman KW, Yu G-P, Schaefer SD. Consequence of Dysphagia in the Hospitalized Patient. Arch Otolaryngol Neck Surg. 2010;136(8):784.CrossRef
3.
Zurück zum Zitat Cabré M, Serra-Prat M, Force L, et al. Oropharyngeal dysphagia is a risk factor for readmission for pneumonia in the very elderly persons: Observational prospective study. Journals Gerontol - Ser A Biol Sci Med Sci. 2014;69A(3):330–337.CrossRef Cabré M, Serra-Prat M, Force L, et al. Oropharyngeal dysphagia is a risk factor for readmission for pneumonia in the very elderly persons: Observational prospective study. Journals Gerontol - Ser A Biol Sci Med Sci. 2014;69A(3):330–337.CrossRef
4.
Zurück zum Zitat Cabre M, Serra-Prat M, Palomera E, et al. Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia. Age Ageing. 2010;39(1):39–45.CrossRefPubMed Cabre M, Serra-Prat M, Palomera E, et al. Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia. Age Ageing. 2010;39(1):39–45.CrossRefPubMed
5.
Zurück zum Zitat Almirall J, Rofes L, Serra-Prat M, et al. Oropharyngeal dysphagia is a risk factor for community-acquired pneumonia in the elderly. Eur Respir J. 2013;41(4):923–926.CrossRefPubMed Almirall J, Rofes L, Serra-Prat M, et al. Oropharyngeal dysphagia is a risk factor for community-acquired pneumonia in the elderly. Eur Respir J. 2013;41(4):923–926.CrossRefPubMed
6.
Zurück zum Zitat Baijens L, Clave P, Cras P, et al. European Society for Swallowing Disorders -European Union Geriatric Medicine Society white Paper: Oropharyngeal Dysphagia as a Geriatric Syndrome. Clin Interv Aging. 2016;11:1–16.CrossRef Baijens L, Clave P, Cras P, et al. European Society for Swallowing Disorders -European Union Geriatric Medicine Society white Paper: Oropharyngeal Dysphagia as a Geriatric Syndrome. Clin Interv Aging. 2016;11:1–16.CrossRef
7.
Zurück zum Zitat Carrión S, Cabré M, Monteis R, et al. Oropharyngeal dysphagia is a prevalent risk factor for malnutrition in a cohort of older patients admitted with an acute disease to a general hospital. Clin Nutr. 2015;34(3):436–442.CrossRefPubMed Carrión S, Cabré M, Monteis R, et al. Oropharyngeal dysphagia is a prevalent risk factor for malnutrition in a cohort of older patients admitted with an acute disease to a general hospital. Clin Nutr. 2015;34(3):436–442.CrossRefPubMed
8.
Zurück zum Zitat Rofes L, Arreola V, Almirall J, et al. Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly. Gastroenterol Res Pract. 2011;2011. pii: 818979.CrossRefPubMed Rofes L, Arreola V, Almirall J, et al. Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly. Gastroenterol Res Pract. 2011;2011. pii: 818979.CrossRefPubMed
9.
Zurück zum Zitat Clavé P, Shaker R. Dysphagia: current reality and scope of the problem. Nat Rev Gastroenterol Hepatol Adv online Publ. 2015;12(5):259–70.CrossRef Clavé P, Shaker R. Dysphagia: current reality and scope of the problem. Nat Rev Gastroenterol Hepatol Adv online Publ. 2015;12(5):259–70.CrossRef
10.
Zurück zum Zitat Cook IJ, Kahrilas PJ, Bloem B, et al. AGA technical review on management of oropharyngeal dysphagia. Gastroenterology. 1999;116(2):455–478.CrossRefPubMed Cook IJ, Kahrilas PJ, Bloem B, et al. AGA technical review on management of oropharyngeal dysphagia. Gastroenterology. 1999;116(2):455–478.CrossRefPubMed
11.
Zurück zum Zitat Clavé P, Terré R, de Kraa M, et al. Approaching oropharyngeal dysphagia. Rev Esp enfermedades Dig. 2004; 96(2):119–131. Clavé P, Terré R, de Kraa M, et al. Approaching oropharyngeal dysphagia. Rev Esp enfermedades Dig. 2004; 96(2):119–131.
12.
Zurück zum Zitat Serra-Prat M, Palomera M, Gomez C, et al. Oropharyngeal dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: A population-based prospective study. Age Ageing. 2012;41(3):376–381.CrossRefPubMed Serra-Prat M, Palomera M, Gomez C, et al. Oropharyngeal dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: A population-based prospective study. Age Ageing. 2012;41(3):376–381.CrossRefPubMed
13.
Zurück zum Zitat Rofes L, Arreola V, Romea M, et al. Pathophysiology of oropharyngeal dysphagia in the frail elderly. Neurogastroenterol Motil. 2010;22(8):1–9.CrossRef Rofes L, Arreola V, Romea M, et al. Pathophysiology of oropharyngeal dysphagia in the frail elderly. Neurogastroenterol Motil. 2010;22(8):1–9.CrossRef
14.
Zurück zum Zitat Ortega O, Martín A, Clavé P. Diagnosis and Management of Oropharyngeal Dysphagia Among Older Persons, State of the Art. J Am Med Dir Assoc. 2017;18(7):576–582.CrossRefPubMed Ortega O, Martín A, Clavé P. Diagnosis and Management of Oropharyngeal Dysphagia Among Older Persons, State of the Art. J Am Med Dir Assoc. 2017;18(7):576–582.CrossRefPubMed
15.
Zurück zum Zitat Serra-Prat M, Hinojosa G, Lõpez D, et al. Prevalence of oropharyngeal dysphagia and impaired safety and efficacy of swallow in independently living older persons. J Am Geriatr Soc. 2011;59(1):186–187.CrossRefPubMed Serra-Prat M, Hinojosa G, Lõpez D, et al. Prevalence of oropharyngeal dysphagia and impaired safety and efficacy of swallow in independently living older persons. J Am Geriatr Soc. 2011;59(1):186–187.CrossRefPubMed
16.
Zurück zum Zitat Suominen M, Muurinen S, Routasalo P, et al. Malnutrition and associated factors among aged residents in all nursing homes in Helsinki. Eur J Clin Nutr. 2005;59(4):578–583.CrossRefPubMed Suominen M, Muurinen S, Routasalo P, et al. Malnutrition and associated factors among aged residents in all nursing homes in Helsinki. Eur J Clin Nutr. 2005;59(4):578–583.CrossRefPubMed
17.
Zurück zum Zitat Marik PE, Kaplan D. Aspiration pneumonia and dysphagia in the elderly. Chest. 2003;124(1):328–336.CrossRefPubMed Marik PE, Kaplan D. Aspiration pneumonia and dysphagia in the elderly. Chest. 2003;124(1):328–336.CrossRefPubMed
18.
Zurück zum Zitat Japanese T, Society R. Aspiration pneumonia. Respirology. 2004;9 Suppl 1:S35–7. Japanese T, Society R. Aspiration pneumonia. Respirology. 2004;9 Suppl 1:S35–7.
19.
Zurück zum Zitat Ortega O, Cabre M, Clave P. Oropharyngeal dysphagia: Aetiology and effects of ageing. J Gastroenterol Hepatol Res. 2014;3(5):1049–1054. Ortega O, Cabre M, Clave P. Oropharyngeal dysphagia: Aetiology and effects of ageing. J Gastroenterol Hepatol Res. 2014;3(5):1049–1054.
20.
Zurück zum Zitat Ortega O, Sakwinska O, Combremont S, et al. High prevalence of colonization of oral cavity by respiratory pathogens in frail older patients with oropharyngeal dysphagia. Neurogastroenterol Motil. 2015;27(12):1804–1816.CrossRefPubMed Ortega O, Sakwinska O, Combremont S, et al. High prevalence of colonization of oral cavity by respiratory pathogens in frail older patients with oropharyngeal dysphagia. Neurogastroenterol Motil. 2015;27(12):1804–1816.CrossRefPubMed
21.
Zurück zum Zitat Ortega O, Martin A, Clave P. Diagnosis and Management of Oropharyngeal Dysphagia Among Older Persons, State of the Art. J Am Med Dir Assoc. 2017; 18(7):576–582.CrossRefPubMed Ortega O, Martin A, Clave P. Diagnosis and Management of Oropharyngeal Dysphagia Among Older Persons, State of the Art. J Am Med Dir Assoc. 2017; 18(7):576–582.CrossRefPubMed
22.
Zurück zum Zitat Ortega O, Clavé P. Oral Hygiene, Aspiration, and Aspiration Pneumonia: From Pathophysiology to Therapeutic Strategies. Curr Phys Med Rehabil Reports. 2013;1(4):292–295.CrossRef Ortega O, Clavé P. Oral Hygiene, Aspiration, and Aspiration Pneumonia: From Pathophysiology to Therapeutic Strategies. Curr Phys Med Rehabil Reports. 2013;1(4):292–295.CrossRef
23.
Zurück zum Zitat Yoneyama T, Yoshida M, Ohrui T, et al. Oral care reduces pneumonia in older patients in nursing homes. J Am Geriatr Soc. 2002;50(3):430–433.CrossRefPubMed Yoneyama T, Yoshida M, Ohrui T, et al. Oral care reduces pneumonia in older patients in nursing homes. J Am Geriatr Soc. 2002;50(3):430–433.CrossRefPubMed
24.
Zurück zum Zitat Yoneyama T, Yoshida M, Matsui T, et al. Oral care and pneumonia. Oral Care Working Group. Lancet (London, England). 1999;354(9177):515.CrossRef Yoneyama T, Yoshida M, Matsui T, et al. Oral care and pneumonia. Oral Care Working Group. Lancet (London, England). 1999;354(9177):515.CrossRef
25.
Zurück zum Zitat Tada A, Hanada N. Opportunistic respiratory pathogens in the oral cavity of the elderly. FEMS Immunol Med Microbiol. 2010;60(1):1–17.CrossRefPubMed Tada A, Hanada N. Opportunistic respiratory pathogens in the oral cavity of the elderly. FEMS Immunol Med Microbiol. 2010;60(1):1–17.CrossRefPubMed
26.
Zurück zum Zitat Tada A, Miura H. Prevention of aspiration pneumonia (AP) with oral care. Arch Gerontol Geriatr. 2012;55(1):16–21.CrossRefPubMed Tada A, Miura H. Prevention of aspiration pneumonia (AP) with oral care. Arch Gerontol Geriatr. 2012;55(1):16–21.CrossRefPubMed
27.
Zurück zum Zitat Sorensen RT, Rasmussen RS, Overgaard K, et al. Dysphagia screening and intensified oral hygiene reduce pneumonia after stroke. J Neurosci Nurs. 2013;45(3):139–146.CrossRefPubMed Sorensen RT, Rasmussen RS, Overgaard K, et al. Dysphagia screening and intensified oral hygiene reduce pneumonia after stroke. J Neurosci Nurs. 2013;45(3):139–146.CrossRefPubMed
28.
Zurück zum Zitat Zuckerman LM. Oral Chlorhexidine Use to Prevent Ventilator-Associated Pneumonia in Adults. Dimens Crit Care Nurs. 2016;35(1):25–36.CrossRefPubMed Zuckerman LM. Oral Chlorhexidine Use to Prevent Ventilator-Associated Pneumonia in Adults. Dimens Crit Care Nurs. 2016;35(1):25–36.CrossRefPubMed
29.
Zurück zum Zitat Scannapieco FA, Yu J, Raghavendran K, et al. A randomized trial of chlorhexidine gluconate on oral bacterial pathogens in mechanically ventilated patients. Crit Care. 2009;13(4):R117.CrossRefPubMedPubMedCentral Scannapieco FA, Yu J, Raghavendran K, et al. A randomized trial of chlorhexidine gluconate on oral bacterial pathogens in mechanically ventilated patients. Crit Care. 2009;13(4):R117.CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Seedat J, Penn C. Implementing oral care to reduce aspiration pneumonia amongst patients with dysphagia in a South African setting. South African J Commun Disord. 2016;63(1):1–11.CrossRef Seedat J, Penn C. Implementing oral care to reduce aspiration pneumonia amongst patients with dysphagia in a South African setting. South African J Commun Disord. 2016;63(1):1–11.CrossRef
31.
Zurück zum Zitat Sjögren P, Nilsson E, Forsell M, et al. A systematic review of the preventive effect of oral hygiene on pneumonia and respiratory tract infection in elderly people in hospitals and nursing homes: Effect estimates and methodological quality of randomized controlled trials. J Am Geriatr Soc. 2008;56(11):2124–2130.CrossRefPubMed Sjögren P, Nilsson E, Forsell M, et al. A systematic review of the preventive effect of oral hygiene on pneumonia and respiratory tract infection in elderly people in hospitals and nursing homes: Effect estimates and methodological quality of randomized controlled trials. J Am Geriatr Soc. 2008;56(11):2124–2130.CrossRefPubMed
32.
Zurück zum Zitat Newman R, Vilardell N, Clavé P, et al. Effect of Bolus Viscosity on the Safety and Efficacy of Swallowing and the Kinematics of the Swallow Response in Patients with Oropharyngeal Dysphagia: White Paper by the European Society for Swallowing Disorders (ESSD). Dysphagia. 2016;31(5):719.CrossRefPubMed Newman R, Vilardell N, Clavé P, et al. Effect of Bolus Viscosity on the Safety and Efficacy of Swallowing and the Kinematics of the Swallow Response in Patients with Oropharyngeal Dysphagia: White Paper by the European Society for Swallowing Disorders (ESSD). Dysphagia. 2016;31(5):719.CrossRefPubMed
33.
Zurück zum Zitat Carrión S, Roca M, Costa A, et al. Nutritional status of older patients with oropharyngeal dysphagia in a chronic versus an acute clinical situation. Clin Nutr. 2017; 36(4):1110–1116.CrossRefPubMed Carrión S, Roca M, Costa A, et al. Nutritional status of older patients with oropharyngeal dysphagia in a chronic versus an acute clinical situation. Clin Nutr. 2017; 36(4):1110–1116.CrossRefPubMed
34.
Zurück zum Zitat Clavé P, Arreola V, Romea M, et al. Accuracy of the volume-viscosity swallow test for clinical screening of oropharyngeal dysphagia and aspiration. Clin Nutr. 2008;27(6):806–815.CrossRefPubMed Clavé P, Arreola V, Romea M, et al. Accuracy of the volume-viscosity swallow test for clinical screening of oropharyngeal dysphagia and aspiration. Clin Nutr. 2008;27(6):806–815.CrossRefPubMed
35.
Zurück zum Zitat Reisberg B, Ferris SH, de Leon MJ, et al. The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry. 1982;139(9):1136–1139.CrossRefPubMed Reisberg B, Ferris SH, de Leon MJ, et al. The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry. 1982;139(9):1136–1139.CrossRefPubMed
36.
Zurück zum Zitat Mahoney FI, Barthel DW. Functional evaluation: The Barthel index. Md State Med J. 1965;14:56–61. Mahoney FI, Barthel DW. Functional evaluation: The Barthel index. Md State Med J. 1965;14:56–61.
37.
Zurück zum Zitat Walter LC, Brand RJ, Counsell SR, et al. Development and validation of a prognostic index for 1-year mortality in older adults after hospitalization. Jama. 2001;285(23):2987–2994.CrossRefPubMed Walter LC, Brand RJ, Counsell SR, et al. Development and validation of a prognostic index for 1-year mortality in older adults after hospitalization. Jama. 2001;285(23):2987–2994.CrossRefPubMed
38.
Zurück zum Zitat Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–383.CrossRefPubMed Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–383.CrossRefPubMed
39.
Zurück zum Zitat Fried L, Tangen C, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol. 2001;56A(3):M146–M156.CrossRef Fried L, Tangen C, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol. 2001;56A(3):M146–M156.CrossRef
40.
Zurück zum Zitat Ortega O, Rofes L, Martin A, et al. A Comparative Study Between Two Sensory Stimulation Strategies After Two Weeks Treatment on Older Patients with Oropharyngeal Dysphagia. Dysphagia. 2016;31(5):706–716.CrossRefPubMed Ortega O, Rofes L, Martin A, et al. A Comparative Study Between Two Sensory Stimulation Strategies After Two Weeks Treatment on Older Patients with Oropharyngeal Dysphagia. Dysphagia. 2016;31(5):706–716.CrossRefPubMed
41.
Zurück zum Zitat Kaiser MJ, Bauer JM, Ramsch C, et al. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging. 2009;13(9):782–788.CrossRefPubMed Kaiser MJ, Bauer JM, Ramsch C, et al. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging. 2009;13(9):782–788.CrossRefPubMed
42.
Zurück zum Zitat Greene JC, Vermillion JR. The symplified oral hygiene index. J Am Dent Assoc. 1964;68:7–13.CrossRefPubMed Greene JC, Vermillion JR. The symplified oral hygiene index. J Am Dent Assoc. 1964;68:7–13.CrossRefPubMed
43.
Zurück zum Zitat Ortega O, Parra C, Zarcero S, et al. Oral health in older patients with oropharyngeal dysphagia. Age Ageing. 2014;43(1):132–137.CrossRefPubMed Ortega O, Parra C, Zarcero S, et al. Oral health in older patients with oropharyngeal dysphagia. Age Ageing. 2014;43(1):132–137.CrossRefPubMed
44.
Zurück zum Zitat The British Dietetic Association and the Royal College of Speech and Language Therapists. National Dysphagia Diet: Standardization for Optimal Care.; 2011. The British Dietetic Association and the Royal College of Speech and Language Therapists. National Dysphagia Diet: Standardization for Optimal Care.; 2011.
45.
Zurück zum Zitat Carrion S. Doctoral Thesis. Fisiopatología de las complicaciones nutricionales asociadas a la disfagia orofaríngea en la población anciana. Universitat Autònoma de Barcelona. 2017. https://www.educacion.gob.es/teseo/mostrarRef.do?ref=1437708. Carrion S. Doctoral Thesis. Fisiopatología de las complicaciones nutricionales asociadas a la disfagia orofaríngea en la población anciana. Universitat Autònoma de Barcelona. 2017. https://​www.​educacion.​gob.​es/​teseo/​mostrarRef.​do?​ref=​1437708.​
46.
Zurück zum Zitat Bass C. An effective method of personal oral hygiene. J La State Med Soc. 1954;106(2):57–73; contd.PubMed Bass C. An effective method of personal oral hygiene. J La State Med Soc. 1954;106(2):57–73; contd.PubMed
47.
Zurück zum Zitat Bass C. An effective method of personal oral hygiene; part II. J La State Med Soc. 1954;106(3):100–112.PubMed Bass C. An effective method of personal oral hygiene; part II. J La State Med Soc. 1954;106(3):100–112.PubMed
48.
Zurück zum Zitat Awano S, Ansai T, Takata Y, et al. Oral health and mortality risk from pneumonia in the elderly. J Dent Res. 2008;87(4):334–339.CrossRefPubMed Awano S, Ansai T, Takata Y, et al. Oral health and mortality risk from pneumonia in the elderly. J Dent Res. 2008;87(4):334–339.CrossRefPubMed
49.
Zurück zum Zitat Terpenning MS, Taylor GW, Lopatin DE, et al. Aspiration pneumonia: Dental and oral risk factors in an older veteran population. J Am Geriatr Soc. 2001;49(5):557–563.CrossRefPubMed Terpenning MS, Taylor GW, Lopatin DE, et al. Aspiration pneumonia: Dental and oral risk factors in an older veteran population. J Am Geriatr Soc. 2001;49(5):557–563.CrossRefPubMed
50.
Zurück zum Zitat Gomes-Filho IS, Passos JS, Da Cruz SS. Respiratory disease and the role of oral bacteria. J Oral Microbiol. 2010;2(2010):1–6. Gomes-Filho IS, Passos JS, Da Cruz SS. Respiratory disease and the role of oral bacteria. J Oral Microbiol. 2010;2(2010):1–6.
51.
Zurück zum Zitat Swan K, Speyer R, Heijnen BJ, Wagg B, Cordier R. Living with oropharyngeal dysphagia: effects of bolus modification on health-related quality of life—a systematic review. Qual Life Res. 2015;24(10):2447–2456.CrossRefPubMed Swan K, Speyer R, Heijnen BJ, Wagg B, Cordier R. Living with oropharyngeal dysphagia: effects of bolus modification on health-related quality of life—a systematic review. Qual Life Res. 2015;24(10):2447–2456.CrossRefPubMed
52.
Zurück zum Zitat Gillman A, Winkler R, Taylor NF. Implementing the Free Water Protocol does not Result in Aspiration Pneumonia in Carefully Selected Patients with Dysphagia: A Systematic Review. Dysphagia. 2017;32(3):345–361.CrossRefPubMed Gillman A, Winkler R, Taylor NF. Implementing the Free Water Protocol does not Result in Aspiration Pneumonia in Carefully Selected Patients with Dysphagia: A Systematic Review. Dysphagia. 2017;32(3):345–361.CrossRefPubMed
53.
Zurück zum Zitat Rosenvinge SK, Starke ID. Improving care for patients with dysphagia. Age Ageing. 2005;34(6):587–593.CrossRefPubMed Rosenvinge SK, Starke ID. Improving care for patients with dysphagia. Age Ageing. 2005;34(6):587–593.CrossRefPubMed
54.
Zurück zum Zitat Shim JS, Oh BM, Han TR. Factors associated with compliance with viscositymodified diet among dysphagic patients. Ann Rehabil Med. 2013;37(5):628–632.CrossRefPubMedPubMedCentral Shim JS, Oh BM, Han TR. Factors associated with compliance with viscositymodified diet among dysphagic patients. Ann Rehabil Med. 2013;37(5):628–632.CrossRefPubMedPubMedCentral
55.
Zurück zum Zitat Beck AM, Kjaersgaard A, Hansen T, et al. Systematic review and evidence based recommendations on texture modified foods and thickened liquids for adults (above 17 years) with oropharyngeal dysphagia–An updated clinical guideline. Clin Nutr. 2017; pii: S0261-5614(17)30317-5. Beck AM, Kjaersgaard A, Hansen T, et al. Systematic review and evidence based recommendations on texture modified foods and thickened liquids for adults (above 17 years) with oropharyngeal dysphagia–An updated clinical guideline. Clin Nutr. 2017; pii: S0261-5614(17)30317-5.
56.
Zurück zum Zitat Rofes L, Arreola V, Mukherjee R, et al. The effects of a xanthan gum-based thickener on the swallowing function of patients with dysphagia. Aliment Pharmacol Ther. 2014;39(10):1169–1179.CrossRefPubMed Rofes L, Arreola V, Mukherjee R, et al. The effects of a xanthan gum-based thickener on the swallowing function of patients with dysphagia. Aliment Pharmacol Ther. 2014;39(10):1169–1179.CrossRefPubMed
57.
Zurück zum Zitat Vilardell N, Rofes L, Arreola V, et al. A Comparative Study Between Modified Starch and Xanthan Gum Thickeners in Post-Stroke Oropharyngeal Dysphagia. Dysphagia. 2016;31(2):169–179.CrossRefPubMed Vilardell N, Rofes L, Arreola V, et al. A Comparative Study Between Modified Starch and Xanthan Gum Thickeners in Post-Stroke Oropharyngeal Dysphagia. Dysphagia. 2016;31(2):169–179.CrossRefPubMed
58.
Zurück zum Zitat Carrión S, Verin E, Clavé P, et al. Complications of Oropharyngeal Dysphagia: Malnutrition and Aspiration Pneumonia. In: Ekberg O, ed. Dysphagia Diagnosis and Treatment. Berlin: Springer; 2012:575–599. Carrión S, Verin E, Clavé P, et al. Complications of Oropharyngeal Dysphagia: Malnutrition and Aspiration Pneumonia. In: Ekberg O, ed. Dysphagia Diagnosis and Treatment. Berlin: Springer; 2012:575–599.
59.
Zurück zum Zitat Norman K, Pichard C, Lochs H, et al. Prognostic impact of disease-related malnutrition. Clin Nutr. 2008;27(1):5–15.CrossRefPubMed Norman K, Pichard C, Lochs H, et al. Prognostic impact of disease-related malnutrition. Clin Nutr. 2008;27(1):5–15.CrossRefPubMed
60.
Zurück zum Zitat Lang NP, Cumming BR, Löe H. Toothbrushing frequency as it relates to plaque development and gingival health. J Periodontol. 1973;44(7):396–405.CrossRefPubMed Lang NP, Cumming BR, Löe H. Toothbrushing frequency as it relates to plaque development and gingival health. J Periodontol. 1973;44(7):396–405.CrossRefPubMed
61.
Zurück zum Zitat Yellowitz JA, Schneiderman MT. Elder’s oral health crisis. J Evid Based Dent Pract. 2014;14 Suppl:191–200.CrossRefPubMed Yellowitz JA, Schneiderman MT. Elder’s oral health crisis. J Evid Based Dent Pract. 2014;14 Suppl:191–200.CrossRefPubMed
Metadaten
Titel
Effect of a Minimal-Massive Intervention in Hospitalized Older Patients with Oropharyngeal Dysphagia: A Proof of Concept Study
verfasst von
A. Martín
O. Ortega
M. Roca
M. Arús
Pere Clavé Civit
Publikationsdatum
17.05.2018
Verlag
Springer Paris
Erschienen in
The journal of nutrition, health & aging / Ausgabe 6/2018
Print ISSN: 1279-7707
Elektronische ISSN: 1760-4788
DOI
https://doi.org/10.1007/s12603-018-1043-3

Weitere Artikel der Ausgabe 6/2018

The journal of nutrition, health & aging 6/2018 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.